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Objectives This report aims to use tetanus hospitalization data to describe the epidemiology in Canada from 1995 to 2019 and to assess progress on national reduction targets, including validating that Canada has eliminated maternal and neonatal tetanus (MNT). Methods Tetanus hospitalizations and fatalities occurring between 1995 and 2019 were retrieved from the Canadian Institute for Health Information (CIHI) and Statistics Canada. Cases coded with ICD-10 codes A33, A34, or A35 as the primary diagnosis (or ICD-9 equivalents) were included. The Canadian national case definition was used for generic tetanus and definitions from the World Health Organization were referenced for MNT. R version 4.0.2 was used for analyses. Results From 1995 to 2019, 155 non-MNT, 6 neonatal, and 0 maternal tetanus cases were retrieved from CIHI. However, all 6 neonatal cases were excluded after validating with provincial/territorial public health officials. In the same time period, there were 91 national notifications of tetanus. Cases were distributed relatively equally across the country, with the exception of the territories, where zero cases were reported. Adults 75 and over had significantly higher incidence rates compared to younger age groups (p Conclusion Tetanus incidence remains low and hospitalization data reveal that Canada has met its reduction target of maintaining 5 cases or fewer annually in recent years. For MNT, Canada has successfully met the elimination target of zero cases. Continued vaccination efforts must be practiced for all age groups, including those aged 75 years and older, to sustain targets moving forward.

Building more homes and amenities in the wildland-urban interface (wui) is not a sustainable practice as it is associated with a greater risk of wildfire, social vulnerability, and ecological damage. Yet, the issue of whether or how to regulate the expansion of the wui remains contentious and largely unresolved in understanding sustainable development. There are fewer studies that explore how wildfire risks are compounded by social vulnerability of people who reside in the fire prone wui. Additionally, much of the extant research is focused on the national or regional level management of ecosystems and forest fires, with a clear lack of focus on local level dynamics. To fill these gaps, our analysis outlines the preliminary steps to identify social vulnerability, ecological damage, and wildfire risk in the wui fire hazard zones of the highest severity type. Utilizing gis mapping, wildfire risk, and census data on social vulnerability, our analysis reveals patterns of the wui expansion in the San Francisco Bay Area from 1990 to 2010 and provides policy recommendations from a sustainable development perspective to address social vulnerability, wildfire risk, and ecological concerns over the wui.

Most men diagnosed with prostate cancer today have organ-confined disease and low risk of disease recurrence after radical prostatectomy. Testosterone deficiency in prostate cancer survivors contributes to impaired health-related quality of life but testosterone treatment is viewed as a contraindication in this population.We describe the design of the first randomized trial to determine the safety and efficacy of testosterone treatment in men who have undergone prostatectomy for non-aggressive prostate cancer and have symptomatic testosterone deficiency.Surviving Prostate cancer while Improving quality of life through Rehabilitation with Testosterone Trial is a randomized, placebo-controlled, double-blind, parallel group trial in 142 men, ≥ 40 years, who have undergone radical prostatectomy for organ-confined prostate cancer, Gleason score ≤ 7 (3+4), Stage pT2, N0, M0 lesions and have symptomatic testosterone deficiency and undetectable prostate specific antigen for 2 years after surgery. Eligible participants are randomized to weekly intramuscular injections of 100-mg testosterone cypionate or placebo for 12 weeks and followed for another 12 weeks. Primary endpoint is change from baseline in sexual activity. Secondary outcomes include change in sexual desire, erectile function, energy, lean and fat mass, physical and cognitive performance. Safety is assessed by monitoring prostate-specific antigen, lower urinary tract symptoms, hemoglobin, and adverse events.The trial is being conducted at two trial sites in Boston, MA and Baltimore, MD. As of July 30, 2022, 42 participants have been randomized. No prostate-specific antigen or clinical recurrence has been noted to-date.Recruitment was slowed by coronavirus disease 2019-related closures, slow subsequent ramp-up of research activities, and patient concerns about safety of testosterone treatment. Despite these challenges, participant retention has been high.The Surviving Prostate cancer while Improving quality of life through Rehabilitation with Testosterone Trial, a placebo-controlled, randomized trial, will determine whether testosterone replacement therapy is safe and efficacious in correcting symptoms of testosterone deficiency in prostate cancer survivors, and potentially inform clinical practice.

Cancer-related cognitive impairments (CRCI) are frequently reported among cancer survivors, and attention is the most frequently assessed cognitive domain in CRCI. However, there is no consensus as to whether attention is impaired. We suggest that a major reason for this lack of agreement is a lack of construct validity for neuropsychological attention tests. We propose to assess the construct validity of neuropsychological attention tests with respect to experimental paradigms from cognitive psychology.Self-reported cancer survivors (N = 314) completed an online battery comprising six experimental attention paradigms and eight neuropsychological tests. Confirmatory factor analysis was used to evaluate the fit of five models derived from a general population sample (N = 636) in a previous study (M. Treviño, Cogn Res Princ Implic, in press). We then subjected the best-fitting model to a measurement invariance analysis.The best-fitting model was a six intercorrelated factor structure, comprising Capacity, Search, Digit Span, Arithmetic, Sustained Attention, and Flanker Interference factors. Configural and weak invariance held, indicating that the factor loadings were invariant across groups. Strong invariance, indicating that intercepts were also invariant, held except for the Approximate Number Sense test.According to our factor model, Spatial Span and Digit Symbol Coding measure attentional capacity, while the Trail Making Test (AB) and Letter Cancellation tests measure visual search ability. However, Digit Span and Arithmetic tests do not measure attention. We hope that these results will lead to better scientific models, better patient education, and, ultimately, improved outcomes for survivors.

PDF file - 41KB, The combination of Y15 and temozolomide decreases more significantly viability of U251 cells than each agent alone.

Invasive

Contexte : Le programme de surveillance circumpolaire internationale assure la surveillance de cinq maladies bactériennes invasives : les pneumococcies invasives, les infections invasives à streptocoque du groupe A, l’Haemophilus influenzae, les infections invasives à méningocoque et les streptocoques du groupe B. Les maladies bactériennes invasives ont une charge de morbidité plus élevée dans les populations nordiques que dans le reste du Canada. Méthodologies : Afin de décrire l’épidémiologie des maladies bactériennes invasives dans le nord du Canada de 1999 à 2018, les données relatives aux pneumococcies invasives, aux infections invasives à streptocoque du groupe A, à l’Haemophilus influenzae, aux infections invasives à méningocoque et aux streptocoques du groupe B ont été extraites du programme de surveillance circumpolaire internationale et du Système canadien de surveillance des maladies à déclaration obligatoire (SSMDO) et analysées. Résultats : Les taux d’incidence annualisés des pneumococcies invasives, des infections invasives à streptocoque du groupe A, de l’Haemophilus influenzae, des streptocoques du groupe B et des infections invasives à méningocoque étaient respectivement de 23,3, 10,5, 8,9, 1,9 et 1,1 pour 100 000 habitants. L’incidence de la pneumococcie invasive, de l’infection invasive à streptocoque du groupe A et de l’Haemophilus influenzae de type b (Hib) était respectivement 2,8, 3,2 et 8,8 fois plus élevée dans le Nord du Canada que dans le reste du pays. Les taux de maladie ont diminué de manière statistiquement significative pour la pneumococcie invasive (β = -0,02) et ont augmenté de manière statistique pour l’infection invasive à streptocoque du groupe A (β = 0,08) et l’Haemophilus influenzae sérotype a (β = 0,04) pendant la période d’étude. Dans le Nord du Canada, les taux d’incidence annualisés des pneumococcies invasives, des infections invasives à streptocoque du groupe A et de l’Haemophilus influenzae étaient statistiquement plus élevés chez les résidents autochtones que chez les résidents non autochtones. Les taux d’incidence les plus élevés ont été enregistrés dans les groupes d’âge très jeunes et plus âgés. Conclusion : Les maladies bactériennes invasives représentent une charge de morbidité importante pour les populations nordiques du Canada. Les peuples autochtones, les enfants et les personnes âgées sont particulièrement exposés.

Objective To characterize strategies among OB-GYN residency programs to recruit underrepresented minorities in medicine, the relative effectiveness of these approaches, and the associated barriers to recruitment. Design We conducted a survey to solicit strategies from OB-GYN PDs at 253 United States (U.S.) accredited programs for recruiting underrepresented minorities in medicine (URiM) applicants. We also sought their relative effectiveness and barriers to recruitment. Setting A national survey of U.S. accredited residency programs in OB-GYN in 2017-2018. Results A total of 56 (22% response rate) PDs responded. Programs reported either “some” or “significant emphasis” on URiM recruitment (77%), with only 32% employing specific recruitment strategies. Fifteen (83%) reported using race and/or ethnicity data in the U.S.’s centralized electronic residency application service, 10 (56%) recruiting applicants from URiM association events, 9 (50%) meeting with potential URiMs prior to official interviews, and 5 (28%) offering a second visit. Efforts perceived to be most effective were second visits (39%), identifying race/ethnicity in electronic residency application service (33%), URiM recruitment events (28%), and individual phone calls (22%). Barriers included the lack of applicant pool (32%), lack of department diversity (29%) and lack of institutional diversity (30%). Conclusions This systematic collation of URiM recruitment practices and perceptions of their effectiveness represents a toolbox of options for residency programs to consider in diversifying their workforce.

The benefits of cancer information-seeking may be particularly salient to individuals impacted by childhood cancer, including patients, caregivers, health professionals, and advocates. The purpose of this study was to explore information-seeking patterns for childhood cancer through the National Cancer Institute's Cancer Information Service (CIS), a multi-channel, bilingual resource for cancer information. The study team conducted descriptive analyses on secondary data characterizing 1820 caregivers, health professionals, organizations, and members of the general public who contacted the CIS about childhood cancer between September 2018 and June 2022. Almost 80% of inquiries about childhood cancer were initiated by caregivers, followed by the public, health professionals, and organizations. Although English was the primary language used by individuals to reach the CIS when discussing childhood cancer, there were variations in points of access (i.e., telephone, instant messaging, email, social media) across the four user groups. Most childhood cancer inquiries were about staging and treatment, and the primary cancer sites discussed by CIS users were neurologic or brain, hematologic, and musculoskeletal cancers. Discussion topics included managing and coping with cancer, clinical trials, and treatment side effects. Just over half (54%) of CIS contacts about childhood cancer resulted in a health professional referral. Findings provide direction for the CIS and other public health organizations to deliver, prioritize, and tailor their services to support the information needs of childhood cancer survivors and their families-as well as those who care and advocate for them-who may have a significant need for credible cancer information.

Background: Atrioventricular nodal re-entrant tachycardia is the most common type of paroxysmal supraventricular tachycardia. We sought to assess whether important anatomic factors, such as the location of the slow pathway, proximity to the bundle of His, and coronary sinus ostium dimensions, varied with patient age, and whether these factors had an impact on procedural duration, acute success, and complications. Methods: Baseline demographic and procedural data were collected, and the maps were analyzed. Linear regression models were performed to evaluate the associations between age and these anatomic variations. Associations were also assessed, with age categorized as being ≥ 60 years or < 60 years. Results: The slow pathway was more commonly located in a superior location relative to the coronary sinus ostium in older patients. The location of the slow pathway moved in a superior direction by 1 mm for every increase in 2 years from the mean estimate of age. Additionally the slow pathway tended to be closer to the coronary sinus ostium in older patients, and the diameter of the ostium was larger in older patients. This resulted in longer procedure time, longer ablation times, and a greater need for long sheaths for stability. Conclusions: The location of the slow pathway becomes more superior and closer to the coronary sinus ostium with increasing age. Additionally, the coronary sinus diameter increases with age. These factors result in longer ablation and procedural times in older patients. Résumé: Contexte: La tachycardie par réentrée nodale auriculoventriculaire est le type le plus fréquent de tachycardie supraventriculaire paroxystique. Nous avons voulu évaluer si des facteurs anatomiques importants, tels que l'emplacement de la voie lente, la proximité du faisceau de His et les dimensions de l'orifice du sinus coronaire (ostium), variaient avec l’âge, et si ces facteurs avaient un effet sur la durée de l'intervention, le succès à court terme et les complications. Méthodologie: Des données sur les caractéristiques démographiques initiales et l'intervention ont été recueillies, et les cartes obtenues ont été analysées. Des modèles de régression linéaire ont servi à déterminer les corrélations entre l’âge et ces variations anatomiques. Les corrélations ont aussi été évaluées selon des catégories d’âge, soit ≥ 60 ans et

Cholangioblastic variant of intrahepatic cholangiocarcinoma (CVICC) is an exceedingly rare primary biliary tract tumor and typically occurs in young patients with a median age of 24.5-year-old. It can mimic metastatic well-differentiated neuroendocrine tumors in the liver with its similar histologic and immunophenotypic features.We hereby report a CVICC in a 68-year-old female patient with distinctive biphasic cytologic features. The patient was diagnosed and treated as a metastatic well differentiated neuroendocrine tumor. The recurrent liver tumor was resected and the tumor cells were strongly positive for Inhibin A and cytokeratin 19 (CK19), focally and weakly positive for synaptophysin and chromogranin, and negative for Insulinoma associated protein 1 (INSM1). Ribonucleic acid (RNA) sequencing showed that the tumor bared a characteristic Nipped-B-like protein (NIPBL)-Nucleus accumbens-associated protein 1 (NACC1) gene fusion.To the best of our knowledge, this is the first documented case in an elder patient of this entity with NIPPL-NACC1 gene fusion. Acknowledgment of the biphasic cytology, screening with Inhibin A in suspicious cases, and coupled with a molecular study may facilitate accurate classification of this aggressive tumor and lead to proper clinical management.

Introduction: Several studies, including our labs, have previously determined the role of estrogen in augmenting EPC-based cardiac repair; however, a direct comparison of therapeutic efficacy of gender-specific stem cells or estrogen-independent mechanisms of gender-specific dimorphism in the reparative properties of BM-EPCs, has not been established. Hypothesis: We hypothesized that epigenetic mechanisms contribute to the sex-specific functional dimorphism of Sca-1+/CD31+ BM-EPCs in regulating cell-homing, pro-angiogenic and anti-inflammatory functions in the ischemic myocardium leading to the enhanced reparative function of female EPCs. Methods: To evaluate our hypothesis, we sorted the male, female and ovariectomized (OVX) mice derived Sca-1+/CD31+ BM-EPCs using MACS multi-sort method. We then subjected the BM-EPCs through a series of cytokine quantifications and epigenetic screening followed by assessment of their therapeutic function in vitro and in vivo . Results: Female and ovariectomized (OVX) female BM-EPCs secrete high levels of pro-angiogenic factors and low levels of pro-inflammatory cytokines compared to male BM-EPCs. Further evaluation of the secretome showed that the male EPCs secreted high levels of interleukins and chemokines compared to female and OVX EPCs. We found that male EPCs exclusively secreted CCL3/Mip-1α. Functional in vitro angiogenic evaluation of the EPC secretome showed higher propensity of female and OVX EPCs than the male EPCs. Post-MI injection of BM-EPCs resulted in remarkable preservation of cardiac structure and functions in both female BM-EPC groups compared to the male EPCs. Male EPC injection resulted in high inflammation in the heart tissue. Epigenetic sequencing of the BM-EPCs for the H3K9me3 mark showed high methylation in male EPCs compared to female and OVX EPCs. The inhibition of histone methyltransferase, Ehmt2/G9a using BIX-01294 upregulated the secretion of inflammatory factors in all EPCs. The conditioned medium from all EPCs with high levels of CCL3 inhibited angiogenesis in vitro . Neutralizing CCL3 in the same medium restored in vitro angiogenesis. Conclusion: Estrogen-independent epigenetic mechanisms govern the enhanced cardiac reparative properties of female BM-EPC.

Hypertrophic cardiomyopathy (HCM) in response to pathophysiological stress is one of the leading causes of heart failure. A growing body of evidence emphasizes the crucial role of exosomes and their modulated content in aggravating cardiac damage due to their inherent intercellular cross-talk abilities during cardiac remodeling. However, the role of circulating exosomes in HCM for the trafficking of pathogenic factors and remodeling the cardiac microenvironment is yet unclear. We investigated the effect of systemic exosome inhibition during cardiac dysfunction in a transverse aortic constriction (TAC) model of heart failure using a recently identified exosome biogenesis inhibitor, Tipifarnib initially developed as Farnesyl transferase inhibitor. In this study, 10-week-old C57BL6J male mice were randomized into three groups i.e., Sham, TAC and Tipifarnib treated (10 mg/kg) TAC. The untreated TAC mice gradually developed hypertrophy and had reduced cardiac functions with a significant increase in heart weight/body weight ratio, cardiomyocyte size and upregulation of hypertrophy and fibrosis associated genes expression by 8 weeks. On the contrary, Tipifarnib treated TAC mice showed remarkably improved cardiac left ventricular functions, reduced cardiac hypertrophy and fibrosis. Notably, Nanosight analysis indicated significantly higher serum exosomes concentration in TAC mice which were substantially suppressed with Tipifarnib treatment. The molecular analysis of the heart tissue revealed Tipifarnib treated TAC mice had reduced expression of the proteins involved in exosome biogenesis in comparison to untreated TAC mice. To gain insight into the cargo of these circulating exosomes, we performed the serum cytokine array and serum exosomes miRNA sequencing in untreated and Tipifarnib treated TAC mice. There was a marked reduction in inflammatory cytokines in serum and differentially expressed exosomal miRNAs with Tipifarnib treatment in comparison to the untreated TAC mice. Overall, our studies suggest the promising potential of Tipifarnib that effectively protects against pressure overload-induced cardiac remodeling and dysfunction by suppressing exosome secretion and altering hypertrophic and fibrotic gene expression.

Background: Recently, skeletal muscle cells (SKMCs) have been reported to be critical for regulation of EC function in limbs. miR-499, a muscle specific microRNA (miR), was found to be modulated in diabetes and ischemic injury. Here, we studied the role of miR-499 in EC dysfunction in diabetic ischemic limb injury. Methods: ECs and SKMCs were isolated from ischemic or non-ischemic hindlimb (IHL) of male db/+ and db/db mice. Serum- and SKMC-derived small extracellular vesicles/exosomes (EV/Exo) were isolated by gradient ultracentrifugation. Ischemic hindlimb (IHL) surgery was conducted by unilateral ligation of formal artery. Results: miR-499-5p level was increased in SKMCs and ECs of db/db mice which was synergistically increased by ischemic injury. Overexpression of miR-499-5p impaired tube formation and migratory activity of ECs. Intramuscular injection of anti-miR-499-5p lentivirus improved blood prefusion and neovascularization in IHL of db/db mice. Mechanistically, miR-499-5p level was enhanced in serum- and SKMC-derived EV/Exo from db/db mice which was synergistically increased by ischemic injury. Diabetic SKMC-EV/Exo impaired blood perfusion in wildtype mice. Anti-miR-499-5p rescued diabetic SKMC-EV/Exo-impaired EC function. Co-culture of diabetic SKMCs with wildtype ECs increased miR-499-5p expression in ECs which was inhibited by EV/Exo inhibitor GW4869. Sex-determining region Y-box 6 (SOX6), the most attractive gene targeted by miR-499-5p, was decreased in ECs from db/db mice which was synergistically reduced by ischemic injury. SOX6 siRNA impaired pro-angiogenic factor secretion and function of ECs. Anti-miR-499-5p significantly enhanced SOX6 level in SKMs from IHL of db/db mice. Finally, overexpression of SOX6 by transduction of lentivirus improved EC function of db/db mice. Conclusions: Enhanced miR-499-5p expression in ECs of SKMs from hindlimb of db/db mice is synergistically increased by ischemic injury. EV/Exo transfer miR-499-5p from SKMCs to ECs. miR-499-5p impairs angiogenic property of EC via, at least partially, SOX6/proangiogenic factors axis. miR-499-5p may be a novel target for treatment of critical limb ischemia in diabetic patients.

The extra-cellular-matrix (ECM) composition of scar tissue after myocardial infarction (MI)has been largely investigated. Although fibronectin and collagen are favorable for newmyocyte formation, other components that may increase the scar stiffness and reducethe remodeling of the ischemic area, remain to be identified. Our preliminary studiesidentified primary Serum Amyloid A3 (SAA3) extracellular accumulation that maycontribute to the chronic alteration of the ischemic myocardium’s scar. Specifichistological staining such as thioflavin and Congo red, showed amyloid deposition inmouse hearts 1 month after MI; furthermore, immunohistochemistry for SAA3 detectedthe deposition of the misfolded protein alongside fibronectin and collagen. Serum amyloidamyloidosis (AA) is characterized by deposition of hepatic misfolded protein and SAA3 isthe only amyloid protein that is released locally after inflammation, mostly bymesenchymal progenitor cells. We have reported earlier that two days after MI, a cohortof mesenchymal cells begin to de novo express Podoplanin (PDPN), a plateletaggregation-inducing type I transmembrane glycoprotein, as a signal of activation.PDPN+ cells, in addition to cytokines, release extracellular vesicles including exosomes(Exo) as major paracrine entities driving intercellular communications in homeostasis anddisease. Exo derived from activated PDPN+ cells isolated from MI hearts highly expressSAA3 and injection of activated PDPN+ cell Exo in uninjured healthy mouse hearts leadsto recruitment of immune cells, an extended epicardial fibrosis and amyloidosis with asubsequent impairment in the contractility and increase of the end systolic volumes anddiameters. SAA3 binds Toll-like receptors, and in vitro treatment of bone marrow derivedmonocytes either with PDPN+ cells derived Exo or recombinant SAA3, activated themtowards pro-inflammatory phenotype on contrary these stimuli failed to activate TLR2knocked out monocytes showing an impairment in the expression of major cytokine,chemokine and pro inflammatory markers. Thus, PDPN+ cells in the ischemic heartrelease SAA3 through Exo prolonging inflammation and macrophage recruitment viaTLR2 and contribute to amyloidosis after MI.

To characterize the circulating androgen levels across the menstrual cycle in healthy women using highly sensitive and accurate methods and report sex differences in the relative levels of dihydrotestosterone (DHT) to testosterone (T) levels.Prospective cohort study.Research clinic, academic teaching hospital.Twenty-one healthy premenopausal women, aged 19-40 years, with regular menstrual cycles.Not applicable.Serum total T and DHT levels measured using liquid chromatography-tandem mass spectrometry, free T levels measured using a standardized equilibrium dialysis method coupled with measurement of the T levels in the dialysate using liquid chromatography-tandem mass spectrometry, and comparison of the DHT-to-T ratio between healthy women and age-matched healthy men.The serum total and free T levels increased across the follicular phase and peaked at midcycle (total T, 43.6 ± 16.2 ng/dL; free T, 15.6 ± 11.9 pg/mL) and gradually declined in the luteal phase. The DHT level did not significantly change across the menstrual cycle. The DHT-to-T ratios were 1:4 and 1:13 in women and men, respectively.In healthy premenopausal women, the total and free T levels varied significantly across the menstrual cycle, whereas the DHT levels did not change; the peak total and free T levels in the midcycle period were higher than previously reported, underscoring the importance of establishing menstrual phase-specific reference ranges to avoid misdiagnosis of hyperandrogenism. Women have significantly higher DHT levels relative to total T than men; the significance of this sex difference in the DHT-to-T ratio needs further investigation.

Background Conventional catheter ablation involves prolonged exposure to ionizing radiation, potentially leading to detrimental health effects. Minimal fluoroscopy (MF) represents a safer alternative, which should be explored. Data on the safety and efficacy of this technique are limited. Hypothesis Our hypothesis is that MF is of equal efficacy and safety to conventional catheter ablation with the use of fluoroscopy by performing a meta‐analysis of both randomized controlled trials (RCTs) and real‐world registry studies. Methods Pubmed and Embase were searched from their inception to July 2020 for RCTs, cohort and observational studies that assessed the outcomes of catheter ablation using a MF technique versus the conventional approach. Results Fifteen studies involving 3795 patients were included in this meta‐analysis. There was a significant reduction in fluoroscopy and procedural time with no difference in acute success (odds ratio [OR]:0.74, 95% CI: 0.50–1.10, p = .14), long‐term success (OR:0.92, 95% CI: 0.65–1.31, p = .38), arrhythmia recurrence (OR:1.24, 95% CI: 0.75–2.06, p = .97) or rate of complications. (OR:0.83, 95% CI: 0.46–1.48, p = .65). Additionally sub‐group analysis for those undergoing catheter ablation for atrial fibrillation (AF) did not demonstrate a difference in success or complication rates (OR:0.86, 95% CI: 0.30–2.42, p = .77). Multivariate meta‐regression did not identify the presence of moderator variables. Conclusion This updated meta‐analysis demonstrated an overall reduction in procedural and fluoroscopy time for those undergoing a minimal fluoroscopic approach. There was no significant difference in either acute or chronic success rates or complications between a MF approach and conventional approach for the management of all arrhythmias including those undergoing catheter ablation for AF.

Design and engineering of bifunctional catalysts are critical in the development of electrochemical full water splitting. In this study, 4-ethylphenylacetylene-functionalized iridium (Ir–C≡, 1.7 ± ...

Nearly 50,000 Canadian children live in foster care. Compared with their peers, foster children experience greater independence and decreased guidance, predisposing them to harmful exposures such as traumatic brain injury (TBI), illicit drugs, and alcohol. Foster children also report a higher level of childhood abuse compared with the general population. This study aimed to: 1) investigate substance/alcohol use disorder, adverse childhood events (ACE), TBI, aggression levels, and the difference between normalized percentages of brain regions of interest (ROIs) in a sample of Canadian youths with and without foster care history; 2) determine the prevalence of substance/alcohol use disorder, ACE, and aggression levels within individuals with foster care history when stratified by likelihood of TBI; and 3) determine the significant correlates of elevated aggression levels within this population. Participants completed standardized questionnaires that measured the prevalence of TBI, substance and alcohol use disorder, ACE, and aggression. Magnetic resonance imaging (MRI) was used to measure differences in brain ROI. Regression and network analysis were used to study interactions between variables. Seventy-four participants (51 individuals with foster care history and 23 age-matched controls from the general population) completed standardized questionnaires. Fifty-five of these individuals (39 foster participants and 16 controls) underwent brain MRI. Foster participants had higher prevalence of substance use disorder (p

Recent articles have highlighted the importance of incorporating implementation science concepts into pandemic-related research. However, limited research has been documented to date regarding implementation outcomes that may be unique to COVID-19 vaccinations and how to utilize implementation strategies to address vaccine program-related implementation challenges. To address these gaps, we formed a global COVID-19 implementation workgroup of implementation scientists who met weekly for over a year to review the available literature and learn about ongoing research during the pandemic. We developed a hierarchy to prioritize the applicability of “lessons learned” from the vaccination-related implementation literature. We identified applications of existing implementation outcomes as well as identified additional implementation outcomes. We also mapped implementation strategies to those outcomes. Our efforts provide rationale for the utility of using implementation outcomes in pandemic-related research. Furthermore, we identified three additional implementation outcomes: availability, health equity, and scale-up. Results include a list of COVID-19 relevant implementation strategies mapped to the implementation outcomes.

Background: Introduction: 1 in 6 Americans has or will have a sensory or communication disorder in their lifetime. In New York, approximately 12.6% of the population is affected by some degree of hearing loss or vestibular dysfunction. Osteopathic medical student auditory screenings have the potential to positively impact communities in screening for auditory disorders. The aim of this study is to argue for the importance of incorporating auditory screening programs into osteopathic student-run health fairs to positively impact underserved communities. Methods: Osteopathic medical students developed an auditory screening protocol and training session to detect auditory pathologies in health fair participants. Screenings included patient intake, hearing loss risk factor discussion questions, and audiological testing such as the whispered voice and turning fork tests. Participants of Touro College of Osteopathic Medicine’s fall and spring health fairs were invited to undergo the screening from September 2017 to March 2018 in New York City, New York. Results: During the inaugural health fairs, 28 participants were screened for auditory pathologies. 6 participants (21%) were referred for additional testing due to abnormal or inconclusive results. Median age of participants was 60 with 19 females and 9 males, IQR 5. Participants primarily self-identified as African American/Black (54%, n=15) or Hispanic (29%, n=8). Conclusion: The results of this pilot project underscore the benefits of effective auditory screening programs at osteopathic student-run health fairs, especially in urban, underserved communities.